Angie's LIST Guide to
The doula's services
Supplementing the expert care of a physician or midwife, the doula focuses specifically on the woman in labor, providing comfort and information throughout pregnancy, birth and beyond. Doulas do not substitute for a midwife or even a partner. Their unique role can enable fathers to participate more fully in the birth by guiding him, helping him understand normal behaviors during labor and reassuring him in the comfort measures he is providing for the mother. While a doula is not for everyone, many women find their service indispensable.
If you are considering hiring a doula, he or she will want to consult with you as soon as possible, perhaps even before you become pregnant, Most initial consultations are free of charge. At this meeting, the doula will explain exactly what he or she can and cannot do. The role of this unique professional varies widely, but most will provide information from the get-go and will be a constant source of comfort until well after the baby is born.
Because the doula will work as a partner with a doctor or midwife, he or she needs to be assertive and speak up for the mother without coming across as pushy. While doulas are sometimes viewed as unnecessary middlemen, most doctors understand that childbirth is more than a medical procedure for the mother and that extra support will make the doctor's job easier.
A doula's job
The job of doulas is physically demanding. They must be physically fit enough to work for hours at a time (often with little sleep), they must be ready to get to work unexpectedly and they may have to attend two or more births back-to-back, with little rest in between.
To become certified, they must undergo a considerable amount of training, including a 16-hour certification course, extensive research and completion of breastfeeding education coursework. Once certified, doulas must continue their education by attending regular workshops to keep their knowledge current. Most importantly, they must be free from judgment, compassionate, and able to handle people under extreme stress.
Throughout pregnancy, they'll provide you with information about what to expect and will help you prepare for any possible scenario. Most women find that this preparation makes them less anxious, and they view labor as an exciting, positive event rather than a clinical medical procedure. The doula's continuous one-on-one support is a great comfort to a woman in labor, as this is often someone who has been with the mother since the beginning of the pregnancy.
While your labor and delivery nurse must come and go, your doula stays with you, and that kind of support is priceless. Most people who have hired doulas agree that the doula was an integral part of the birthing experience. Studies indicate that women who birth with doulas present tend to exhibit more postpartum affection, and their infants spend less time in the hospital, have fewer admissions to special care nurseries and breastfeed more readily. Women who employ doulas during childbirth are less likely to need pain medication or a Cesarean section, though this is far from a guarantee.
Choosing a doula
Some hospitals can provide a woman with a doula; in most cases, she must hire one independently. Most hospitals recognize the value of the doula and will welcome one in the labor room. A good starting point is Doulas of North America. This organization provides you with a "find a doula" link that will direct you to a local doula in your area. When you're ready to hone in, Angie's List is a great place to find member reviews and ratings of local doulas. Most will consult with you free of charge and then design a plan that best suits your situation.
Fees vary widely depending on geographic location: a ballpark figure for the entire service is between $900 and $2,000. Most will work out a payment plan with you. Some insurance companies have begun to cover doula services in their policies. Check your your insurance provider who may also have certain doulas in your network and may require a referral from your general practitioner or obstetrician.
The initial interview is a great way to get to know your prospective doula: You'll know right away if you have the right chemistry. If you find a doula who can weather the rigors of training and the difficult working conditions, you have found a unique person indeed.